Systematic Reviews
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 28, 2016; 22(28): 6547-6558
Published online Jul 28, 2016. doi: 10.3748/wjg.v22.i28.6547
Epidemiology of functional gastrointestinal disorders in infants and toddlers: A systematic review
Ana Paula Ferreira-Maia, Alicia Matijasevich, Yuan-Pang Wang
Ana Paula Ferreira-Maia, Yuan-Pang Wang, Institute and Department of Psychiatry (LIM-23), University of São Paulo Medical School, São Paulo 01060-970, SP, Brazil
Alicia Matijasevich, Department of Preventive Medicine, University of São Paulo Medical School, São Paulo 01246-903, SP, Brazil
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: No potential conflicts of interest. No financial support.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Yuan-Pang Wang, MD, PhD, Institute and Department of Psychiatry (LIM-23), University of São Paulo Medical School, R. Dr. Ovídio Pires de Campos, 785, São Paulo 01060-970, SP, Brazil.
Telephone: +55-11-26616976 Fax: +55-11-26616976
Received: March 29, 2016
Peer-review started: April 4, 2016
First decision: May 12, 2016
Revised: May 26, 2016
Accepted: June 28, 2016
Article in press: June 29, 2016
Published online: July 28, 2016

AIM: To assess the functional gastrointestinal disorders (FGID) prevalence in infants and toddlers.

METHODS: PubMed, EMBASE, and Scopus were searched for original articles from inception to February 2016. The literature search was made in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). For inclusion, each study had to report epidemiological data of FGID on children up to 4 years old and contain standardized outcome Rome II or III criteria. The overall quality of included epidemiological studies was evaluated in accordance to Loney’s proposal for prevalence studies of health literature. Two reviewers assessed each study for inclusion and extracted data. Discrepancies were reconciled through discussion.

RESULTS: It was identified a total of 101 articles through the databases and two through the manual search. A total of 28 articles fulfilled the eligibility criteria. After reading the full articles, 13 of them were included in the present review. Twelve studies were written in English and one in Chinese, and published between 2004 and 2015. Eight articles (61.5%) were performed in Europe, three (23.1%) in America and two (15.4%) in Asia. Sample size varied between 45 and 9660 subjects. Cross-sectional frequency was reported in majority of studies (k = 9) and four studies prospectively followed the subjects. 27.1% to 38% of participants have met any of Rome’s criteria for gastrointestinal syndromes, of those 20.8% presented two or more FGID. Infant regurgitation and functional constipation were the most common FGID, ranging from less than 1% to 25.9% and less than 1% to 31%, respectively. Most included studies were of moderate to poor data quality with respect to absence of confidential interval for prevalence rate and inadequate sampling methods.

CONCLUSION: The scarcity and heterogeneity of FGID data call for the necessity of well-designed epidemiological research in different levels of pediatric practice and refinement of diagnostic.

Keywords: Infant, Functional gastrointestinal disorders, Epidemiology, Prevalence, Toddler

Core tip: Epidemiological studies on functional gastrointestinal disorders in infants and toddlers provide variable prevalence rates in both pediatric outpatient and inpatient practice. A number of investigations and reviews have been conducted using Rome’s criteria for functional disorders to depict the magnitude of the problem, however, few investigations have reported meaningful results with adequate methodology. The current literature review suggested higher impact of pediatric feeding and defecation problems that affect very young children, respectively infant regurgitation and functional constipation.